I discussed in an earlier SharePost how the mental health community is beginning to accept the idea that men tend to exhibit depressive symptoms differently than women. Instead of feeling sadness, a man may feel angry or irritable. Instead of losing interest in activities he previously enjoyed, a man may drink too much or engage in risky behavior.

Now that it’s easier to recognize depression symptoms in a man we know, our next step is to talk to him about it. However, that’s easier said than done. I was involved with a man who went through bouts of depression. It was understandable – he had had a rough childhood and had a parent who was mentally ill. I knew when he was going through a bout – he would drink heavily. But when I would bring up the topic, he would insist that he wasn’t depressed – he was just “in a funk.”

If you want to talk to a man about depression, or have already tried, you may be realizing that it’s a tough subject. The biggest stumbling block may be the threat that being depressed poses to a man’s masculinity. (By the way, I absolutely hate generalizing about any group of people, but unfortunately it’s essential here). If we look at some of the icons of manhood – John Wayne, James Bond, Clint Eastwood – they all have one thing in common. They’re stoic and unemotional. Not the best role models for a man when he’s struggling with depression. Following their example, he would never talk about how he feels about anything, let alone something like depression.
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Antidepressants in the SSRI family don’t appear to be any more effective than a placebo in treating any but the most severely depressed people. That’s the conclusion of a study published last week in the Public Library of Science Medicine. The study analyzed trial results, both published and unpublished, of six widely prescribed SSRIs. The researchers found that a placebo worked just as well as the SSRIs for people with mild or moderate depression.

I don’t find these conclusions particularly surprising. To my mind, there are very few situations in which someone with mild depression should be prescribed an antidepressant. Actually, I can’t think of even one, but bear in mind that I’m not a doctor. However, I think that most doctors would agree that other approaches are as effective, such as talk therapy and exercise. Whether or not moderate depression should be treated with antidepressants is a little more complicated. My take on it is that antidepressants shouldn’t necessarily be the first line of defense.
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